{"doi":"10.3389/fpubh.2025.1593285","title":"Association between daily variations in the levels of atmospheric O3, PM2.5, and NO2 and the frequency of hospital visits due to respiratory diseases and hypertension in Mexico City using Generalized Additive Mixed Models","abstract":"Background Environmental pollution is a significant public health issue in Mexico City. Patients with respiratory or cardiovascular diseases such as asthma or hypertension often experience exacerbations triggered by environmental factors. This retrospective time series epidemiological study analyzed the association between daily air pollution levels and the numbers of medical visits for exacerbations of cardiorespiratory diseases. Methods Records from primary, secondary, and tertiary hospitals of the Mexican Institute of Social Security (IMSS) were reviewed between 2017 and 2019. Air quality data, including PM 2.5 , PM 10 , O 3 , and NO 2 concentrations were collected hourly from air quality monitoring stations at fixed sites. To fit the models and take into account temporal autocorrelation and the complex non-linear relationships between pollutants and cardiorespiratory diseases, Generalized Additive Mixed Models (GAMM) were applied. Results PM 2.5 , O3, and NO2 exposure showed a strong association with an increase in visits for upper respiratory diseases. Age was a relevant factor: individuals aged between 19–35 years were the most affected, whereas those aged 66–100 years were least affected. An effect on the weekdays was identified, with peaks in visits on Mondays and decreases on Saturdays. Also, seasonally, results showed an increase in October and declines in August. Regarding hypertensive diseases, only PM 2.5 exhibited an association. The models confirmed the link between air pollution levels and respiratory disease exacerbations, highlighting key public health implications. Conclusion This study provides strong evidence that short term exposure to elevated concentrations of atmospheric pollutants, specifically PM 2.5 , O3, and NO2, are significantly associated with an increase in medical visits for upper respiratory diseases, asthma, and hypertension in Mexico City. By employing Generalized Additive Mixed Models and analyzing health records from IMSS-affiliated hospitals between 2017 and 2019, we observed that the effects of air pollution varied by disease, age group, season, and day of the week.","journal":"Frontiers in Public Health","year":2025,"id":573896,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9146,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1481005,"name":"Alejandro Ruíz-Olivares","orcid":"0000-0003-0328-5833","position":1,"is_corresponding":false},{"id":1481006,"name":"Yosune Miquelajauregui","orcid":"0000-0001-7084-7782","position":2,"is_corresponding":false},{"id":1481418,"name":"Regina Rentería-Campos","orcid":null,"position":3,"is_corresponding":false},{"id":1481007,"name":"Lindsay Bramwell","orcid":"0000-0003-1795-8736","position":4,"is_corresponding":false},{"id":1481419,"name":"Romain Bernard M. Feytmans","orcid":null,"position":5,"is_corresponding":false},{"id":1481008,"name":"Anil Namdeo","orcid":"0000-0002-0982-9590","position":6,"is_corresponding":false},{"id":1338635,"name":"Juan Carlos Núñez-Enríquez","orcid":"0000-0002-8070-9727","position":7,"is_corresponding":false},{"id":1481009,"name":"Jane Entwistle","orcid":"0000-0002-4375-4502","position":8,"is_corresponding":false},{"id":1481420,"name":"Mónica Jaimes-Palomera","orcid":null,"position":9,"is_corresponding":false},{"id":1481421,"name":"Nancy Minerva Torres-Rojas","orcid":null,"position":10,"is_corresponding":false},{"id":1481010,"name":"Ramón Alberto Rascón-Pacheco","orcid":"0000-0002-2480-6100","position":11,"is_corresponding":false},{"id":1405417,"name":"David Aldebarán Duarte-Rodríguez","orcid":"0000-0002-0560-2540","position":12,"is_corresponding":false},{"id":1481011,"name":"Richard McNally","orcid":"0000-0001-6685-6467","position":13,"is_corresponding":false},{"id":1481012,"name":"Jimena García-Burgos","orcid":"0000-0003-1960-4632","position":14,"is_corresponding":false},{"id":1481422,"name":"Cinthia Gabriela Resendiz-Martinez","orcid":null,"position":15,"is_corresponding":false},{"id":1481423,"name":"Ángel Fragoso-Chino","orcid":null,"position":16,"is_corresponding":false},{"id":476686,"name":"Louise Hayes","orcid":"0000-0001-6442-4150","position":17,"is_corresponding":false},{"id":1481013,"name":"Antonio Portas","orcid":"0000-0001-9897-9832","position":18,"is_corresponding":false},{"id":62956,"name":"Juan Manuel Mejía‐Aranguré","orcid":"0000-0001-8027-6231","position":19,"is_corresponding":false},{"id":1481004,"name":"Elizabeth Vega","orcid":"0000-0003-2954-950X","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:57:36.753600Z","pmid":"40963658","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}